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Clinical Case Reports May 2023We described the first case of granular parakeratosis with an unusual presentation of brown discoloration plaques and multiple erythematous on the dorsal part of the...
KEY CLINICAL MESSAGE
We described the first case of granular parakeratosis with an unusual presentation of brown discoloration plaques and multiple erythematous on the dorsal part of the patient's hands. Skin maceration and repeated washing could have led to the development of the lesions.
ABSTRACT
Granular parakeratosis is a unique acquired keratinization disorder. Here, we described the abnormal presentation of granular parakeratosis. A healthy female aged 27 years old presented brown discoloration plaques and multiple erythematous on the dorsal part of her hands for 8 months. Using detergents, repeated washing, and skin maceration were considered the causes of her lesion.
PubMed: 37180336
DOI: 10.1002/ccr3.7338 -
Indian Journal of Dermatology 2023Psoriasis is a chronic, immune-mediated skin disorder characterised by well-demarcated erythematous plaque with micaceous scale. Naevoid Blaschkoid psoriasis is an...
Psoriasis is a chronic, immune-mediated skin disorder characterised by well-demarcated erythematous plaque with micaceous scale. Naevoid Blaschkoid psoriasis is an unusual subtype that occurs along Blaschko lines. A two-year-old boy presented with erythematous scaly lesions distributed along the lines of Blaschko over the bilateral upper limb, the front of the chest, back, and the right lower limb. The lesions appeared four months ago and slowly progressed. There was no history of trauma, no skin lesions in other parts of the body, and no significant family history. Nail and mucosa were normal. Histopathology showed psoriasiform dermatitis with characteristics of psoriasis. The child was treated with topical clobetasol propionate 0.05% cream. Naevoid Blaschkoid psoriasis, in the absence of psoriatic lesion elsewhere on the body, is a rare manifestation. It has striking similarity with inflammatory linear verrucous epidermal nevus (ILVEN), both clinically and histologically. Naevoid psoriasis usually presents late, is asymptomatic or mildly pruritic, progresses rapidly, and responds favourably to antipsoriatic treatment. In contrast, ILVEN presents early, is intensely pruritic, slowly progressive, and is usually refractory to antipsoriatic treatment. Histologically, ILVEN demonstrates abruptly alternating areas of hypergranulosis with orthokeratosis, and parakeratosis with agranulosis. An inflammatory infiltrate is present in the upper dermis. Psoriasis presents with papillomatosis, acanthosis, and parakeratosis with absent or minimal granular layer. Immunohistochemical staining can be done in such doubtful cases. Involucrin would be detectable in psoriasis, but it is absent in ILVEN. Pathogenesis of linear psoriasis is unknown but might be explained by the concept of genetic mosaicism. Although rare, there have been a few reported cases of linear psoriasis occurring in early childhood.
PubMed: 37151253
DOI: 10.4103/ijd.ijd_894_22 -
JAAD Case Reports May 2023
PubMed: 37078017
DOI: 10.1016/j.jdcr.2023.02.006 -
Dermatology Reports Mar 2023Erosive pustular dermatosis of the scalp (EPD) is a rare condition that affects predominantly the adult population and occurs on a previously photo-damaged bald scalp....
Erosive pustular dermatosis of the scalp (EPD) is a rare condition that affects predominantly the adult population and occurs on a previously photo-damaged bald scalp. The physical examination is presented with large erythematous, erosive and crusted patches with granulation on an atrophic skin. The problem in patients with erosive pustular dermatosis of the scalp arises from the non-specific clinical and histopathological findings, which can be misleading. Biopsy followed by careful histopathological verification is mandatory, although the finding is nonspecific. The histopathology findings are characterized by superficial erosions with mild neutrophil infiltrate, mainly intravascular and focally with neutrophil exocytosis; focal parakeratosis, smoothed rete ridges without pronounced interface changes; pronounced lymphoplasmacytic infiltrate with focal distribution in the dermis and giant cell reaction with the formation of a "foreign body" granuloma.. We report a 58-year-old male patient with a 1-year-old lesion, suspected for skin cancer, later diagnosed with EPDS, which was successfully treated with topical clobetasol proprionate after 3-5weeks.
PubMed: 37063403
DOI: 10.4081/dr.2022.9556 -
International Journal of Surgical... Feb 2024Duchenne muscular dystrophy (DMD) is characterized by progressive systemic muscle wasting, leading to respiratory paralysis and early death. This X-linked disease is...
Duchenne muscular dystrophy (DMD) is characterized by progressive systemic muscle wasting, leading to respiratory paralysis and early death. This X-linked disease is caused by mutations, encoding dystrophin. There is little information regarding gastrointestinal abnormalities in patients with DMD. However, since the esophageal wall includes smooth and skeletal muscle it is also vulnerable to suffering the effects of muscle wasting in patients with DMD. After finding dyskeratosis and parakeratosis restricted to the proximal and middle esophagus with distal sparing in an 18-year-old patient with DMD, we performed an archive search of a large academic hospital and identified four additional patients with DMD who had also undergone esophageal biopsy. The patients consisted of five boys, ranging from 7 to 19 years of age. Esophageal injury was present in two patients, consisting of mild esophagitis in one, and spongiosis with dyskeratosis and parakeratosis in another. These patients were both older and had been diagnosed with DMD for greater than 15 years, while the three patients with histologically normal biopsies were younger and been diagnosed with DMD for 7, 9, and 13 years, respectively. Although the data is limited and the changes are subtle, they can be explained by the underlying muscular dystrophy pathophysiology.
Topics: Adolescent; Humans; Male; Esophagus; Muscle, Skeletal; Muscular Dystrophy, Duchenne; Mutation; Parakeratosis; Child; Young Adult
PubMed: 37063046
DOI: 10.1177/10668969231167532 -
Photodiagnosis and Photodynamic Therapy Jun 2023Granular parakeratosis is characterized by variably hyperkeratotic brownish papules or plaques, mostly found on flexures. Different treatments have been suggested with...
Granular parakeratosis is characterized by variably hyperkeratotic brownish papules or plaques, mostly found on flexures. Different treatments have been suggested with variable results. We present a series of 3 cases successfully treated with one session of methyl-aminolevulinate photodynamic therapy, showing resolution of the lesions and symptoms within less than 2 weeks, as a potentially new, safe and effective therapeutic option.
Topics: Humans; Parakeratosis; Photochemotherapy; Photosensitizing Agents; Aminolevulinic Acid
PubMed: 37037402
DOI: 10.1016/j.pdpdt.2023.103562 -
Clinical, Cosmetic and Investigational... 2023Granular parakeratosis is a rare dermatosis characterized by erythematous scaly patches or papules, and plaques, often involving intertriginous areas. In this work, a...
Granular parakeratosis is a rare dermatosis characterized by erythematous scaly patches or papules, and plaques, often involving intertriginous areas. In this work, a 73-year-old Chinese male patient presented with a 6-month history of pruritic verrucous papules on the bilateral groin. A skin biopsy was performed and revealed the following: the horny layer showed highly compact hyperkeratosis and parakeratosis with basophilic granules; the epidermis showed obvious acanthosis with psoriasiform hyperplasia. The final diagnosis was verrucous granular parakeratosis. We also reviewed the progress in nomenclature, etiology, clinical manifestations, differential diagnosis and treatment. Different clinical manifestations may represent different clinical entities. Dermatologists should differentiate it from other diseases to make a correct diagnosis. Treatment options should be based on the variable etiologies and clinical manifestations.
PubMed: 37033787
DOI: 10.2147/CCID.S401799 -
International Journal of Surgery Case... Apr 2023Nevus comedonicus (NC) is a rare cutaneous disorder thought to be caused by hamartomatous pilosebaceous tissue proliferation that was first described in 1895. Clinically...
INTRODUCTION
Nevus comedonicus (NC) is a rare cutaneous disorder thought to be caused by hamartomatous pilosebaceous tissue proliferation that was first described in 1895. Clinically NC appears as a group of elevated follicular openings often linearly arrayed, giving the appearance of comedones. NC usually manifests at birth but can also present later during adolescence and rarely in adulthood.
CASE PRESENTATION
A 21-year-old medically healthy single male presented with right-sided chest black papules in comedo distribution with areas of superficial ulcerations and suppurations in periareolar distribution since the age of 16. Histopathological examination showed dilated follicular ostia filled with keratin plug, devoid of the hair shaft, and lined by stratified squamous epithelium with compact hyperkeratosis, focal parakeratosis, and patchy atrophy and acanthosis.
CLINICAL DISCUSSION
Nevus comedonicus often responds effectively to conservative treatment, however some cases need surgery intervention. The patient failed conservative medical and topical treatment, and he was treated by surgical-wide local excision and primary closure of the affected skin with free nipple grafting.
CONCLUSION
Nevus comedonicus (NC) is a rare cutaneous pathology secondary to pilosebaceous apparatus developmental defect that usually manifests at birth and can affect any area of skin; they typically manifest as black papules in comedo distribution. They can present as an isolated cutaneous pathology or as a component of nevus comedonicus syndrome. Different therapeutic approaches were described, including topical retinoids, keratolytic agents, oral retinoids, antibiotic therapy, manual extraction of comedos, dermabrasion, and surgical resection of the lesion.
PubMed: 37001367
DOI: 10.1016/j.ijscr.2023.108021 -
Tropical Animal Health and Production Mar 2023This study aimed to investigate the effect of rumen pH-adjusting additives in the high-concentrated diet on functional traits, nutrient digestion, some meat parameters,...
Comparison of the effect of Saccharomyces cerevisiae-Megasphaera elsdenii and buffer on growth performance, digestibility, ruminal histomorphometry, and carcass characteristics of fattening lambs in high concentrate diet.
This study aimed to investigate the effect of rumen pH-adjusting additives in the high-concentrated diet on functional traits, nutrient digestion, some meat parameters, and histomorphometry, and rumen histopathology. Twenty-four Arabia male lambs with 3 to 4 months old and initial body weight of 23.9 ± 3.15 kg were used in a completely randomized design with three treatments and eight replicates. The study was 77 days, including 14 days of the adaptation period and 63 days of the record taking and sampling period. The experimental treatments consisted of a control diet, control diet + sodium bicarbonate buffer, control diet + Megasphaera elsdenii, and Saccharomyces cerevisiae (bacterial-yeast). Rumen fluid was taken by stomach tube at 3 h after morning feeding to measure pH. The lambs were weighed every 3 weeks during the period, and the body weight changes, average daily gain, and total weight gain were measured, and the feed conversion ratio was calculated. At the end of the experiment, the lambs were slaughtered, and the longissimus dorsi muscle was prepared to determine the meat parameters. For histological studies, the abdominal rumen sac was sampled. There were no differences among treatments in dry matter intake (DMI), daily weight gain (ADG), and feed conversion ratio (P > 0.05). Propionate concentration was higher in the bacteria-yeast treatment than other treatments (P < 0.05). Protein digestibility was higher in control and bacteria-yeast treatments than buffer treatment (P < 0.05). The percentage of meat protein, carcass weight, and dressing percentage in bacterial-yeast treatment was higher than other treatments (P < 0.05). Rumen wall thickness in the buffer and bacterial-yeast receiving treatments was greater than the control treatment and was significant in the buffer treatment compared to the control treatment (P < 0.05). The thickness of rumen epithelial tissue in the buffer and bacterial-yeast recipient treatments was less than the control treatment (P < 0.05). Rumen papillae thickness was higher in the control treatment than other treatments (P < 0.05). Hydropic degeneration and parakeratosis were less in pH-regulating treatments than in control. The results showed that the use of Megasphaera elsdenii could be an effective way to modulate the ruminal fermentation conditions of lambs fed with high concentrate diets. In addition, to increaseing dressing percentage and meat protein, it can also reduce tissue damage and improve ruminal tissue structure.
Topics: Sheep; Animals; Male; Saccharomyces cerevisiae; Megasphaera elsdenii; Rumen; Diet; Sheep, Domestic; Fermentation; Meat Proteins; Body Weight; Animal Feed; Digestion
PubMed: 36977895
DOI: 10.1007/s11250-023-03532-4